医院临床感染性疾病常见病原菌分布及耐药情况分析  

Analysis of distribution and antibacterial resistance of common pathogenic bacteria of clinical infectious diseases in hospital

作　　者：蒋开龙[1] 代作林[1] 秦冬梅[1] 张丽[1] 

机构地区：[1]四川省大英县人民医院,四川遂宁629300

出　　处：《国际检验医学杂志》2015年第18期2708-2710,共3页International Journal of Laboratory Medicine

摘　　要：目的分析引起临床感染性疾病的常见病原菌的临床分布特征及耐药情况,为治疗感染性疾病、合理应用抗菌药物及有效控制医院感染提供科学依据。方法对2012年8月至2013年7月分离自门诊及住院患者的常见病原菌的分布状况及耐药性进行分析,采用MicroScan WorkAway 40全自动细菌鉴定/药敏分析仪进行病原菌鉴定和药敏试验,并运用WHONET5.5对药敏结果进行分析。结果共分离病原菌1 434株,其中革兰阴性菌占53.8%,革兰阳性菌占28.1%,其他病原菌占18.1%;耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率分别为31.6%、57.4%;未检出耐万古霉素的葡萄球菌;耐万古霉素肠球菌(VRE)检出率为8.8%;产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌检出率分别为47.2%、12.2%;葡萄球菌、肠球菌属细菌对万古霉素、利奈唑胺、莫西沙星较敏感,耐药率低于10.0%;葡萄球菌对青霉素类、大环内酯类、奎诺酮类、四环素、头孢类均有较强的耐药性,耐药率大于30.0%;大多革兰阴性菌对厄他培南、亚胺培南、阿米卡星、美洛培南、哌拉西林/他唑巴坦、替卡西林/克拉维酸、左氧氟沙星较敏感,耐药率低于10.0%。结论应加强医院病原菌分布特征及耐药性监测,为指导临床各科室合理使用抗菌药物提供参考依据。Objective To analyse distribution and antibacterial resistance of common pathogenic bacteria of clinical infectious diseases and provide scientific basis for the treatment of infectious diseases ,rational use of antibacterial agents and nosocomial infec‐tion control .Methods The distribution and antibacterial resistance of common pathogens clinically isolated from inpatients and out‐patients from August 2012 to July 2013 were analyzed .Bacterial identification and drug susceptibility test were carried out by using MicroScan WorkAway 40 automated bacterial identification and drug‐susceptibility analyzer ,and the results of drug susceptibility test were analysed by using the WHONET5 .5 software .Results A total of 1 434 strains of pathogenic bacteria were isolated ,and gram‐negative bacteria ,gram‐positive bacteria and other pathogenic bacteria accounted for 53 .8% ,28 .1% and 18 .1% respectively . The detection rate of methicillin‐resistant Staphylococcus aureus and methicillin‐resistant coagulase negative Staphylococcus were 31 .6% and 57 .4% respectively .No strains of vancomycin‐resistant Staphylococcus were found ,while strains of vancomycin‐resist‐ant Enterococcus faecium accounted for 8 .8% .The detection rate of extended‐spectrum beta‐lactamases producing Escherichia coli and Klebsiella pneumoniae were 47 .2% and 12 .2% respectively .Isolates of Staphylococcus and Enterococcus faecium were sensi‐tive to vancomycin ,linezolid and moxifloxacin ,and the resistance rates were less than 10 .0% .While isolates of Staphylococcus were resistant to the penicillin ,macrolides ,quinolones ,tetracycline ,cephalosporin ,and the resistance rates were more than 30 .0% .Most isolates of gram‐negative bacteria were sensitive to ertapenem ,imipenem ,amikacin ,meropenem ,piperacillin/tazobactam ,ticarcillin/clavulanic acid and levofloxacin ,and the resistance rates were less than 10 .0% .Conclusion It is necessary to enhance monitoring of distribution and antibacterial resistance of pathogenic bact

关 键 词：感染性疾病 病原菌 抗菌药物 耐药性 

分 类 号：R446.5[医药卫生—诊断学]